Background: Nausea and vomiting occurs in approximately 60% of all pregnancies and is usually self limiting. When nausea and vomiting persists and results in significant fluid and electrolyte abnormalities it is called hyperemesis gravidarum. Hyperemesis gravidarum occurs up to 20 weeks gestations at a rate of 4 per 1000 pregnancies. Hyperemesis gravidarum is felt to be the result of a central effect on the vomiting center in the brain. Several small case series have demonstrated significant and prompt improvement in nausea and vomiting related to hyperemesis gravidarum with the administration of corticosteroids. To date there has been no prospective randomized study to evaluate the usefulness of corticosteroids in the treatment of hyperemesis gravidarum. Purpose: To evaluate the effectiveness of corticosteroids in the treatment of hyperemesis gravidarum in patients that fail initial routine therapy.